Continuous Puncture Method for Abdominal Puncture With Respiratory Variation by Deriving Puncture Initiation Timing that Minimizes IntraCycle Error

CT-guided percutaneous puncture stands as a valuable and minimally invasive treatment method, alleviating the burden on physicians. Despite its advantages, accurate puncture in the presence of organ variation due to respiration remains a challenge, especially with thin needles. Existing methods addressing respiratory variation often fall short in efficiently performing punctures using ultrafine needles due to the risk of needle buckling and the time-consuming nature of discontinuous punctures in specific phases. This study aims to develop a continuous puncture method tailored for ultrafine needles, assuming zero puncture error in specific respiratory phases. We devised a method to determine the optimal puncture initiation timing by modeling the mechanism underlying puncture errors resulting from respiratory variation in the abdomen. Micro- and macroscale error generation models were integrated to simulate the final puncture error. Using human respiratory data, we developed a method to minimize intracycle error by determining the puncture initiation timing. Validation involved collecting respiratory data from six individuals and conducting puncture experiments with a device replicating measured respiration variation. The results affirm the effectiveness of this method in achieving continuous and accurate punctures with ultrafine needles.